Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$558.00
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$930.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$67.37 with UPMC Health Plan vs $818.40 with National Provider Network — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $67.37 | ↓ -88% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $105.87 | ↓ -81% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $106.70 | ↓ -81% |
| Aetna of PA | Medicare | $107.77 | ↓ -81% |
| UPMC Health Plan | CHIP | $183.61 | ↓ -67% |
| Occunet | Commercial | $279.00 | ↓ -50% |
| Geisinger | Medicaid/CHIP | $306.90 | ↓ -45% |
| PA Health & Wellness | PA Medicaid HMO | $306.90 | ↓ -45% |
| United Healthcare | Commercial | $324.57 | ↓ -42% |
| UPMC Health Plan | Commercial | $418.50 | ↓ -25% |
| Cigna | Commercial | $438.96 | ↓ -21% |
| Highmark Wholecare (prev Gateway) | Medicare | $465.00 | ↓ -17% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $697.50 | ↑ +25% |
| Humana | Commercial | $744.00 | ↑ +33% |
| National Provider Network | PPO | $818.40 | ↑ +47% |
| Aetna | Medicaid | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $243.00 | $67.37 – $317.46 |
| UPMC Mercy | Pittsburgh | $384.00 | $67.37 – $106.70 |
| UPMC Passavant-McCandless | Pittsburgh | $3,681.60 | $105.03 – $131.24 |
| Uniontown Hospital | Uniontown | $143.50 | $126.52 – $294.79 |